Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, New Jersey.
Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, New Jersey.
Am J Prev Med. 2018 May;54(5):630-636. doi: 10.1016/j.amepre.2018.01.033. Epub 2018 Mar 15.
This study examined pneumococcal vaccine coverage in adults aged 19-64 years newly diagnosed with diabetes, chronic heart, lung, or liver disease. These conditions are indicated for pneumococcal vaccination by the Advisory Committee on Immunization Practices.
A retrospective cohort analysis was conducted in 2016 using the Truven Health MarketScan® database. The study population was adults aged 19-64 years with at least one new chronic condition during 2009-2013 and continuous health plan enrolment for 2 years before and 1 year after the initial diagnosis. Vaccine coverage by length of follow-up since diagnosis (ranging from 1 to 5 years) was summarized. Multivariate analyses were performed to understand factors associated with vaccination.
A total of 552,942 adults aged 19-64 years with chronic conditions were identified. There were 8% of adults newly diagnosed with one of four chronic conditions that received a pneumococcal vaccination after 1 year of follow-up; the proportion increased to 20.1% among those with 5 years of follow-up data. Adults aged 50-64 years were more likely to be vaccinated than those aged 19-49 years. Adults with diabetes were more likely to be vaccinated than adults with chronic heart, lung, or liver disease. Adults enrolled in HMO plans were more likely to be vaccinated than adults in other plan types. A higher number of healthcare encounters increased the likelihood of vaccination. Adults who received influenza vaccination were also more likely to receive a pneumococcal vaccination.
Vaccine coverage remains well below Healthy People 2020 targets. A substantial number of adults with chronic conditions remain unvaccinated and at risk for pneumococcal disease.
本研究调查了新诊断患有糖尿病、慢性心脏、肺部或肝脏疾病的 19-64 岁成年人的肺炎球菌疫苗接种覆盖率。这些疾病符合免疫实践咨询委员会推荐肺炎球菌疫苗接种的条件。
2016 年，我们使用 Truven Health MarketScan®数据库进行了一项回顾性队列分析。研究人群为年龄在 19-64 岁之间的成年人，在 2009-2013 年期间至少患有一种新的慢性疾病，并且在初始诊断前 2 年和后 1 年连续参加健康计划。总结了自诊断以来（1 至 5 年）的疫苗接种覆盖率。进行了多变量分析以了解与接种相关的因素。
共确定了 552,942 名患有慢性疾病的 19-64 岁成年人。在诊断后 1 年随访的成年人中，有 8%患有四种慢性疾病之一的成年人接种了肺炎球菌疫苗；在随访 5 年的成年人中，这一比例增加到 20.1%。50-64 岁的成年人比 19-49 岁的成年人更有可能接种疫苗。患有糖尿病的成年人比患有慢性心脏、肺部或肝脏疾病的成年人更有可能接种疫苗。参加 HMO 计划的成年人比参加其他计划类型的成年人更有可能接种疫苗。就诊次数的增加增加了接种疫苗的可能性。接种流感疫苗的成年人也更有可能接种肺炎球菌疫苗。
疫苗接种率仍远低于 2020 年健康人目标。大量患有慢性疾病的成年人未接种疫苗，仍面临肺炎球菌疾病的风险。
